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Introduction: Doravirine/lamivudine/tenofovir disoproxil fumarate (DOR/3TC/TDF) is recommended for both ART initiation and switch in virologically suppressed patients. We report early real-world outcomes after DOR/3TC/TDF introduction in Belgrade, Serbia.

Methods: We conducted a single-center retrospective study at the Clinic for Infectious and Tropical Diseases, University Clinical Center of Serbia, including all adults who initiated or switched to DOR/3TC/TDF between May 2024 and April 2025. Demographics, comorbidities, prior ART, adverse events, and laboratory data (CD4, HIV-1 RNA, triglycerides, total and LDL cholesterol) were abstracted from electronic records.

Results: Of 260 participants, 75 were treatment-naïve and 185 switched regimens; median follow-up was 7 months (IQR: 1-11 months). In naïve patients, CD4 counts increased (458.2±312.0 to 580.7±262.8 cells/μL; p=0.007) and viral load fell to undetectable in 82.8% (24/29; p=0.002). In switch patients, CD4 counts remained stable (665.0±317.5 to 660.5±268.0; p=0.891) and suppression was maintained, with rates of undetectable viral load rising from 83.2% to 93.1% (p=0.013). No significant short-term changes were observed in triglycerides, total cholesterol, or LDL. No virological failures occurred; one discontinuation due to rash was recorded.

Conclusions: In routine care in Belgrade, once-daily DOR/3TC/TDF was well tolerated and effective: naïve patients achieved rapid suppression with CD4 gains, and switch patients maintained high rates of undetectable viral load without adverse lipid shifts. These findings support DOR/3TC/TDF as a practical option in the Serbian setting.

Introduction: Antimicrobial resistance is a significant public health issue worldwide, associated with limited treatment options and with major consequences for healthcare systems. Our study aims to assess rates and patterns of resistance to five last-resort antimicrobials in a cohort of carbapenemase-producing Klebsiella pneumoniae strains, isolated over a one-year interval. Additionally, we have tested two potentially synergistic combinations for in vitro efficacy.

Methods: This prospective observational study evaluated Klebsiella pneumoniae strains with diminished carbapenem susceptibility from patients admitted to the National Institute for Infectious Diseases "Prof. Dr. Matei Balş" in Bucharest between August 2023 and July 2024. Strains presenting a minimum inhibitory concentration to meropenem of >0.125 μg/mL underwent phenotypic enzyme production testing, followed by synergistic testing to identify antimicrobial salvage therapy options. A subset of these strains was analysed for the detection of plasmid-mediated resistance genes, using a custom workflow for DNA extraction and amplification/detection.

Results: A total of 139 non-duplicate strains were isolated, with 129 (92.8%) being carbapenemase producers. These 129 strains were phenotypically diverse: 29 (22.5%) were NDM, 12 (9.3%) OXA-48 type, 8 (6.2%) KPC, while most of them (62.0%) were double carbapenemase producers: 79 (61.2%) NDM and OXA-48-type, and one strain was NDM and KPC. Forty-six strains were resistant to cefiderocol (35.7%), 108 (83.7%) to ceftazidime/avibactam, 127 (98.4%) to ceftolozane/tazobactam, 116 (90.0%) to imipenem/relebactam and 127 (98.4%) to aztreonam. The association of aztreonam with ceftazidime/avibactam demonstrated a synergistic effect in 127 (98.5%) strains, while aztreonam with imipenem/relebactam was efficient in vitro against 103 (79.8%) strains.

Conclusions: Antimicrobial resistance remains a concerning phenomenon among Enterobacterales, especially when considering the increasing resistance rates even against salvage therapy antimicrobials.

Hepatitis B virus (HBV), hepatitis delta virus (HDV), and hepatitis C virus (HCV) remain leading drivers of chronic viral hepatitis, cirrhosis, hepatocellular carcinoma, and liver-related mortality. This ESCMID Study Group for Viral Hepatitis (ESGVH) narrative review summarizes recent advances and expert perspectives in the field. For HBV, emerging biomarkers such as quantitative HBs antigen, HBV RNA, and hepatitis B core-related antigen offer opportunities to refine monitoring and to individualize treatment. HDV epidemiology is evolving, and is being increasingly studied; in parallel, the approval of bulevirtide represents a major breakthrough in therapy, with further agents in the HDV pipeline. For HCV, direct-acting antivirals provide curative therapy and have made elimination a realistic goal, while identifying remaining gaps in diagnosis, linkage-to-care, and equitable access offers clear opportunities to accelerate progress. Together, these advances bring the goal of a hepatitis-free future closer than ever.

Influenza remains a common cause of hospitalization among children, bringing substantial morbidity and mortality rates. Despite its soaring prevalence, a significant gap in therapeutic interventions persists, especially for the pediatric population. We present a literature review detailing clinical trials or case reports published in the last six years (since 2019) that discuss the prevention or treatment of influenza in children. We used search engines such as PubMed or Cochrane Library. All studies/case reports are written in English, and all the clinical trials are finished. In Europe, oseltamivir, zanamivir, and baloxavir marboxil are recommended for the treatment or prophylaxis of influenza in adults and children, while the Food and Drug Administration added intravenous peramivir to the list of anti-influenza drugs. Oseltamivir remains the first line of treatment and chemoprophylaxis. However, there are still discussions related to the duration of prophylaxis, with shorter periods of administration being explored, or the most efficient treatment dosage program (whether it is the conventional dosage of 3 mg/kg/dose for children <40 kg or 75 mg for adults, twice daily, compared to a double dosage administration program). When faced with an old disease, it is essential to constantly assess the efficacy of conventional molecules and dosages, along with new antivirals or complementary medication.

Owing to significant advances in HIV treatment and the resultant increase in life expectancy, the number of aging individuals living with HIV and associated comorbidities continues to rise. Consequently, the management of people living with HIV is no longer solely the responsibility of infectious disease or HIV specialists, but requires an integrated and multidisciplinary approach that addresses the prevention, as well as the monitoring and treatment needs of associated conditions. The care of people living with HIV in Romania is largely aligned with international guidelines, particularly those of the European AIDS Clinical Society (EACS). However, guideline implementation requires adaptation to local clinical realities and collaboration across medical specialties. In response to this need, a team of experts in infectious diseases, cardiology, nephrology, diabetes, metabolic disorders, and clinical psychology, convened to develop a national consensus for the interdisciplinary management of people living with HIV. The consensus provides clear and practical recommendations addressed to both infectious disease specialists and healthcare providers from other specialties involved in the care of people living with HIV. Its goal is to offer a unified, up-to-date, and applicable framework to support patient-centered care, facilitate interdisciplinary collaboration, and contribute to improving the quality of life of people living with HIV in Romania.

Introduction: Brain abscess is defined as a suppurative collection resulting from hematogenous dissemination as an extension from otorhinolaryngologic infectious foci, or secondary to cranial trauma and neurosurgical procedures. Its evolution follows four histopathological stages, the most severe complication being intraventricular rupture, which is associated with extremely high mortality. Central nervous system infections caused by multidrug-resistant (MDR/XDR) Acinetobacter baumannii are rare but severe, significantly limiting therapeutic options due to the reduced penetration of the blood-brain barrier by active antimicrobial agents.

Case report: We report the case of a 48-year-old patient with a history of hemorrhagic stroke treated surgically, who was admitted for fever, severe headache, and vomiting. On admission, lumbar puncture confirmed bacterial meningitis, with isolation of A. baumannii susceptible only to colistin. Brain magnetic resonance imaging revealed a postoperative cerebellar abscess. Initial empirical therapy consisted of meropenem and vancomycin, subsequently adjusted according to the susceptibility profile to cefiderocol, intravenous and intrathecal colistin, combined with ampicillin/sulbactam and minocycline. The clinical course was favorable with regard to meningitis, with partial regression of the cerebellar abscess. Follow-up lumbar punctures were sterile, and the patient's neurological condition stabilized, allowing avoidance of neurosurgical drainage.

Conclusions: Meningitis and brain abscess caused by MDR A. baumannii represent rare clinical entities with potentially severe outcomes. Intrathecal administration of colistin, in combination with systemic multidrug therapy, proved decisive in controlling the infection. An interdisciplinary approach and individualized antimicrobial regimens are essential to achieving a favorable prognosis in such complex cases.

Viral hepatitis remains a global health concern, with growing recognition of the impact of hepatitis A virus (HAV), hepatitis E virus (HEV), and herpesvirus-associated hepatitis, particularly in vulnerable groups. This narrative review from the ESCMID Study Group for Viral Hepatitis (ESGVH) summarizes recent advances and expert perspectives. For HAV, insights into viral evolution, epidemiology, and risk groups underline the preventable nature of severe disease. HEV is increasingly recognized as both a hepatotropic and a systemic pathogen, with expanding knowledge on natural and vaccine-induced immunity. Herpesvirus-associated hepatitis, while rare, poses significant challenges, especially in patients with immunosuppression or during pregnancy, where early suspicion and empirical antiviral therapy can be lifesaving. Collectively, these evolving insights highlight the importance of strengthened diagnostics, targeted prevention, and tailored management strategies to mitigate the burden of these underappreciated but clinically significant causes of viral hepatitis.

Introduction: This study aimed to better understand patient-reported human papillomavirus (HPV) vaccination rates and barriers to vaccination among transgender patients receiving care at a gender-affirming clinic in urban New York.

Methods: All patients with arrived appointments at the Center for Transgender Care at Northwell Health from January 1, 2020 through July 14, 2021, aged 14 and up, were invited to participate. Participants were sent an online consent form followed by a survey that assessed HPV knowledge, personal vaccination history, and reasons for or against vaccination. Data were collected in RedCap and analyzed using descriptive and basic inferential statistics. We received 79 completed consent forms and 70 completed surveys.

Results: At least 68 of the 70 participants identified as transgender or gender diverse. Only 61.4% (43/70) of participants reported ever being offered the HPV vaccine and 55.7% (39/70) reported ever receiving at least one dose. Common reasons in favor of vaccination included doctor recommendation and decreasing cancer risk. Common reasons mentioned against HPV vaccination included sexual inactivity, concern over side effects, and assumption of low-risk HPV status. Of unvaccinated participants, 58.1% (18/31) reported they were more likely to get vaccinated after completing the survey.

Conclusions: The HPV vaccination rate in this study was higher than the rates seen in previous studies involving sexual and gender minority participants. Provider recommendation was found to be important in promoting vaccination.

Introduction: Genitourinary syndrome of menopause (GSM) and vulvovaginal atrophy (VVA) significantly impact women's quality of life, leading to symptoms such as vaginal dryness, irritation, dyspareunia, and urinary incontinence. While traditional treatments include hormonal therapy and surgical interventions, these approaches may not be suitable for all patients. Laser vaginal rejuvenation has emerged as a promising, minimally invasive alternative that enhances vaginal tissue health with minimal downtime.

Methods: This retrospective study analyzes data from 53 patients who underwent internal, external, or combined laser vaginal rejuvenation. Patient demographics, medical and gynecological history, treatment indications, procedural details, and post-treatment outcomes were assessed.

Results: The most common reasons for seeking treatment included vaginal laxity (69.8%), urinary incontinence (47.2%), and vaginal discomfort (15.1%). The majority (90.6%) opted for combined internal and external treatment, with most undergoing three sessions. Post-procedure symptoms were minimal, limited to transient discomfort and minor, self-limiting bleeding in three patients. No patients developed wound infections.

Conclusions: Findings suggest laser vaginal rejuvenation is a well-tolerated procedure, with high adherence and patient satisfaction rates. While our current study is limited by its descriptive nature and its single-center design, results align with existing literature, supporting the procedure's safety and efficacy.